Acute cardiac care & resuscitationSecondary analysis
Identifying clinical subtypes in acute dyspnoea patients admitted to the emergency department: a secondary model-based clustering of prospective cohorts
- secondary model-based clustering of prospective cohorts
- latent class analysis
- derivation cohort (LEDA)
- external validation (BASEL V)
Authors' conclusion
A model-based clustering approach identified four reproducible acute dyspnoea subtypes with distinct clinical, biomarker, and prognostic profiles. This framework may improve early risk stratification and personalized ED management beyond nosologically classified diagnoses.
Study context
- Population
- Adults presenting to the emergency department with acute dyspnoeatwo prospective emergency department (ED) cohorts · LEDA 1,392 · BASEL V 1,886
- Comparison
- Subtypes were compared regarding clinical characteristics, biomarker profiles, and 90-day mortality
Primary result
As reported in the abstract
Subtypes identified
- four reproducible subtypes were identified
- Subtypes transcended conventional diagnostic categories
Further findings
3-month mortality, subtype D
| Comparison | adjusted HR (95% CI) | P value | |
|---|---|---|---|
| ‘hypoxemic’ (D) · LEDA · After adjusting for traditional risk factors · comparator group not stated | 3.87 (2.17–6.87) | P < 0.0001 | |
| ‘hypoxemic’ (D) · BASEL V · After adjusting for traditional risk factors · comparator group not stated | 5.15 (2.71–9.76) | P < 0.001 | |
| 0.10.31310Adjusted hazard ratio (log scale) |
Inflammatory and cardiovascular biomarker levels
- increased significantly from A to D
- all P < .001
Harrell C-index for 3-month mortality, adding subtype membership
- LEDA
- 0.73 to 0.77, P = .04
- BASEL V
- 0.76 to 0.79, P = .03
- beyond a linear combination of the three main class-defining variables
Original publication
Identifying clinical subtypes in acute dyspnoea patients admitted to the emergency department: a secondary model-based clustering of prospective cohorts. ESC Heart Fail. Published 25 August 2026. doi:10.1093/eschf/xvag225
Summarised from the published abstract; every number is checked against it